Primary hepatic sarcomas in children--a single-center experience over 19 years

J Pediatr Surg. 2010 Nov;45(11):2124-8. doi: 10.1016/j.jpedsurg.2010.07.016.

Abstract

Background/purpose: Primary hepatic sarcomas are rare and account for about 13% of primary hepatic neoplasms. There are few reported series of pediatric hepatic sarcomas, and the aim was to review our experience.

Methods: A retrospective analysis of cases managed from 1988 to 2007 by the pediatric liver unit in Birmingham, UK, was conducted.

Results: Nineteen children were identified. These presented with sudden abdominal pain (n = 6), obstructive jaundice (n = 3), incidental mass (n = 3), and chronic pain/distension (n = 3). Vascular involvement was identified in 3, and 6 had pulmonary metastases. Three patients had primary resection, and 3 only a biopsy. Thirteen had a biopsy followed by chemotherapy and resection. Surgery included extended hepatectomy (n = 11), hepatectomy (n = 3), and nonanatomical resections (n = 2). There was 1 major intraoperative complication. Median inpatient stay was 7 days. One biliary leak developed 4 weeks postoperatively. Five of the 16 patients who underwent resection of the primary tumor died. Eleven were alive at a median follow-up of 3 years.

Conclusion: This is a challenging group of patients. Local control remains pivotal to successful treatment. Good results can be achieved in a specialist center with multidisciplinary approach.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Angiography
  • Antineoplastic Agents / therapeutic use*
  • Biopsy
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Hepatectomy / methods*
  • Humans
  • Infant
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / surgery
  • Magnetic Resonance Imaging
  • Male
  • Retrospective Studies
  • Sarcoma / diagnosis*
  • Sarcoma / drug therapy
  • Sarcoma / surgery
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Antineoplastic Agents